(An Iowa Capital Dispatch report) – A Des Moines surgeon accused of negligence and wrongful death has agreed to pay a $2,500 civil penalty for inadequate management of medical records in the case. According to the Iowa Board of Medicine, Dr. Marc Miller performed an outpatient, robotic-assisted laparoscopic hernia repair on a male patient on May 22, 2020. The patient was discharged later that day. The following day, the patient reported intense pain and swelling and was advised by Miller that the condition was normal and would likely resolve itself in a few days, the board alleges.

According to the board, Miller did not direct the patient to the emergency room or advise him to seek other forms of medical attention, and no entries were created in the patient’s medical record to document the report of pain and swelling. Ultimately, the patient decided to go the emergency room on the afternoon of May 26, 2020, due to continued pain and swelling. His condition deteriorated as he went into septic shock, emergency surgery was performed and the patient died a few days later.

Earlier this month, more than five years after the patient’s death, the Iowa Board of Medicine charged Miller with one count of improper management of medical records in the case. To settle the case, Miller agreed to accept a warning from the board and pay a $2,500 civil penalty. In addition, he agreed to complete what the board calls a “live, interactive course on medical records documentation.” Court records indicate the patient in the hernia-repair case was a Polk County man, and that the surgery was performed at the surgical clinic of UnityPoint Health in Des Moines. According to the man’s estate, which later sued Miller for wrongful death, Miller perforated the bowel during surgery, failed to discover the error during the course of the operation, and then closed the incision.

The lawsuit alleged the patient called Miller the next day to report severe pain and swelling. Miller said the patient’s intense pain was ‘normal’ and would take quite a few days to go away.” The lawsuit alleges the patient “remained in intense pain for the next several days,” and told others he was in “agony” to the point where he couldn’t even try to lay down on the bed. On May 26, 2020, the lawsuit alleged, the patient spoke to one of Miller’s agents, who reiterated Miller’s assurance that the pain was normal and did not require medical intervention. Several hours later, the patient “decided on his own to go to the emergency room” where he went into septic shock and emergency surgery was performed. “During surgery, he went into cardiac arrest and had to be given CPR for 20 minutes and shocked five times,” the lawsuit alleged. “He suffered overwhelming multisystem organ failure … and died on May 29, 2020.”

Miller and UnityPoint Health denied any wrongdoing. In May 2023, a lawsuit filed by the patient’s family, was settled out of court. The terms of the settlement were not made public.